Immediate release multilayer tablet

ABSTRACT

Described herein, in part, are tablets, such as immediate release multi-layer or bilayer tablets for orally delivering olanzapine and samidorphan, methods of using said tablets in the treatment of disorders described herein, and kits comprising said tablets.

CROSS-REFERENCE

This application is a continuation of U.S. patent application Ser. No.17/855,242, filed Jun. 30, 2022, which is a continuation ofInternational Application Number PCT/EP2021/081585 filed Nov. 12, 2021,which claims priority to U.S. Provisional Application No. 63/113,067filed Nov. 12, 2020, each of which is incorporated herein by referencein its entirety.

BACKGROUND

Antipsychotic medications are among the most important therapeutic toolsfor treating various psychotic disorders. There are two categories ofantipsychotics, typical and atypical. Typical antipsychotics e.g.,haloperidol and chlorpromazine, were first developed in the 1950's andwere used to treat psychosis, particularly schizophrenia. Common sideeffects of typical antipsychotics include: dry mouth, tremors, weightgain, muscle tremors, and stiffness. In addition, typical antipsychoticsyield extrapyramidal side effects. These side effects include: motordisturbances, parkinsonian effects, akathesia, dystonia, akinesia,tardive dyskinesia, and neuroleptic malignant syndrome. Some of theseside effects have been described to be worse than the actual symptoms ofschizophrenia. Atypical antipsychotics are considered to be the firstline of treatment for schizophrenia because of the improvedextrapyramidal side effect profile in comparison to typicalantipsychotics. Atypical antipsychotics are also associated withsuperior tolerability, adherence and relapse prevention and have led toimproved treatment for patients with serious mental illness.

However, antipsychotics are also associated with significant weightgain. Clinical studies have reported that 40-80% of patients underchronic atypical antipsychotic treatment experience substantial weightgain, e.g., exceeding their ideal body weight by 20%, and increases therisk of obesity. Weight gain was found to be greatest with clozapine,olanzapine, risperidone, and quetiapine, and less with aripiprazole andziprasidone. Obesity is a leading cause of mortality as it frequentlyleads to conditions such as diabetes and cardiovascular disorders. Inaddition, where atypical antipsychotics are increasingly prescribed tochildren and adolescents with psychiatric disorders, young children whotake antipsychotics risk long term health risks associated with rapidweight gain, for example, metabolic changes that could lead to diabetes,hypertension and other illnesses.

Olanzapine is2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno[2,3-b][1,5]benzodiazepine.The molecular formula of olanzapine is: C₁₇H₂₀N₄S and the molecularweight is 312.44 g/mol. It is a yellow crystalline powder and has pKavalues of 7.80 and 5.44. The chemical structure is:

Samidorphan is an opioid antagonist (also known as3-carboxamido-4-hydroxynaltrexone) that preferentially acts as anantagonist of the μ-opioid receptor. Samidorphan L-malate ismorphinan-3-carboxamide, 17-(cyclopropylmethyl)-4, 14-dihydroxy6-oxo-,(2S)-2-hydroxybutanedioate. The molecular formula of samidorphanL-malate is C₂₁H₂₆N₂O₄·C₄H₆O₅ and the molecular weight is 504.54 g/mol.It is a white to off-white crystalline powder and has pKa values of 8.3(amine) and 10.1 (phenol). The chemical structure is:

Samidorphan (as Samidorphan L-malate) in combination with olanzapine ismarketed by Alkermes as LYBALVI®, which is indicated for the treatmentof schizophrenia in adults, bipolar I disorder in adults, acutetreatment of manic or mixed episodes as monotherapy and as adjunct tolithium or valproate.

U.S. Pat. No. 10,300,054 discloses a composition comprising samidorphanor derivatives thereof and an antipsychotic including olanzapine.

Therefore, there is a continuing need to develop more effectiveantipsychotic drug treatments that e.g., reduce weight gain, and thatare in easy to use formulations that minimize the need for significantlymultiple tablets for administration.

SUMMARY

Described herein, in part, are tablets (e.g., immediate releasemulti-layer tablets such as bi-layer tablets) for orally deliveringolanzapine and samidorphan for treatment of psychotic and otherdisorders as described herein. Disclosed compositions, e.g., disclosedtablets, that include samidorphan and its associated pharmaceuticallyacceptable salts, together with olanzapine can provide a once-daily,oral atypical antipsychotic therapeutics that provides the efficacy ofolanzapine while mitigating olanzapine-associated weight gain, Thisdisclosure, in part, is directed to tablets that provide a substantiallyimmediate release profile upon administration to a patient but includeboth samidorphan and olanzapine. For example, although olanzapine may besusceptible to degradation in the presence of samidorphan (e.g.,olanzapine and samidorphan are chemically incompatible, this disclosureis directed in part to multi-layer tablets having both olanzapine andsamidorphan in a unit formulation that also provides reduced relatedimpurities formation (for example, under typical storage conditions(e.g., 25° C./60% relative humidity and 40° C./75% relative humidity),and can release both samidorphan and olanzapine substantially quicklyonce administered.

Multi-layer tablets as disclosed herein have the advantage offacilitating simultaneous administration to patients, in need thereoftherapeutically effective combinations of olanzapine and samidorphan.The disclosure contemplates multi-layer tablets as well as a bilayertablet comprising one olanzapine containing layer and one samidorphan(or a pharmaceutically acceptable salt thereof) containing layer, whichmay be preferred as it simplifies the production process. Multi-layerfixed dose combination tablets comprising of olanzapine and samidorphan(or the equivalent of a pharmaceutically acceptable salt thereof) whichhave been found to be particularly useful are those comprising a firstlayer having about 10 mg or 20 mg of samidorphan (or salt thereof e.g.13.6 mg or 27.2 mg of samidorphan L-malate), and a second layer havingbetween 2.5 mg and about 20 mg of olanzapine, preferably about 2.5 mg, 5mg, 10 mg, 15 mg or 20 mg of olanzapine. Multilayer tablets of thepresent invention may optionally comprise a barrier layer of inertmaterial between respective layers of samidorphan and olanzapine. Such abarrier layer serves to maintain physical distance between the activeingredient and prevent their interaction or mixing.

Apart from the active ingredients, olanzapine and samidorphan, tabletsof the invention may comprise pharmaceutically acceptable excipientswhich confer advantages in terms of processability, stability of thedosage form and/or aiding release of active ingredient(s) from thedosage form. Each layer may separately comprise pharmaceuticallyacceptable excipients such as: diluents, glidants, disintegrants andlubricants. Preferred excipients include microcrystalline cellulose,crospovidone (also known as polyvinyl pyrrolidone or PVP), lactose(anhydrous or hydrates), silicon doxide and magnesium stearate, usedseparately or in combinations. Additional preferred excipients aredescribed below. It is preferable, although not required, for the sameexcipients to be used in each active ingredient containing layer of thetablet.

For example, described herein as an embodiment is a pharmaceuticallyacceptable coated immediate release bilayer tablet for orally deliveringolanzapine and 10 mg of samidorphan as a fixed dose, comprising: a firsttablet layer comprising 10 mg samidorphan or a pharmaceuticallyacceptable salt of samidorphan in an amount to deliver 10 mgSamidorphan, about 30-45 wt % microcrystalline cellulose, based on theweight of the first tablet layer, about 35-50 wt % lactose or a hydratethereof, based on the weight of the first tablet layer; and about 0.5 toabout 2 wt % magnesium stearate, a second tablet layer comprising: adose of olanzapine selected from the group consisting of 2.5 mg, 5 mg,10 mg, 15 mg and 20 mg of the olanzapine, about 35-45 wt %microcrystalline cellulose, based on the weight of the second tabletlayer, about 45-55 wt % lactose or a hydrate thereof, based on theweight of the second tablet layer; and about 1.0 wt % magnesiumstearate, and a film coating over the first and second tablet layer.

Also described herein as an embodiment is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering olanzapineand 10 mg of samidorphan as a fixed dose, comprising: a first tabletlayer comprising:10 mg samidorphan or a pharmaceutically acceptable saltof samidorphan (e.g., samidorphan L-malate) in an amount to deliver 10mg samidorphan; about 35-43 wt % microcrystalline cellulose, based onthe weight of the first tablet layer; about 37-43 wt % lactose or ahydrate thereof, based on the weight of the first tablet layer; andabout 1.5 to about 2 wt % magnesium stearate; a second tablet layercomprising: a dose of olanzapine selected from the group consisting of 5mg, 10 mg, 15 mg and 20 mg of the olanzapine; about 38-42 wt %microcrystalline cellulose, based on the weight of the second tabletlayer; about 46-49 wt % lactose or a hydrate thereof, based on theweight of the second tablet layer; and about 1.0 wt % magnesiumstearate; and a film coating over the first and second tablet layer.

Also provided for herein is a pharmaceutically acceptable coatedimmediate release bilayer tablet for orally delivering olanzapine (e.g.,2.5 mg, 5 mg, 10 mg, 15 mg or 20 mg olanzapine), together with 10 mg ofsamidorphan as a fixed dose, comprising: a first tablet layercomprising: 13.6 mg samidorphan L-malate; about 40 wt % microcrystallinecellulose, based on the weight of the first tablet layer; about 42 wt %lactose monohydrate, based on the weight of the first tablet layer; andabout 1.75 wt % magnesium stearate; a second tablet layer comprising: adose of olanzapine, for example, a dose of olanzapine selected from thegroup consisting of 2.5 mg, 5 mg, 10 mg, 15 mg and 20 mg of theolanzapine; about 40 wt % microcrystalline cellulose, based on theweight of the second tablet layer; about 47 wt % lactose or a hydratethereof, based on the weight of the second tablet layer; and about 1.0wt % magnesium stearate; and a film coating over the first and secondtablet layer.

In one embodiment, described herein is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering olanzapineand samidorphan (e.g., 10 mg of samidorphan) together as a fixed dose,comprising: a first tablet layer (for example, having 10 mg samidorphan,or a pharmaceutically acceptable salt of samidorphan (e.g., samidorphanL-malate) in an amount to deliver 10 mg samidorphan); and a secondtablet layer having, for example, 2.5 mg, 5 mg, 10 mg, 15 mg or 20 mg ofolanzapine, and a film coating; wherein the tablet releases at least 80%of both the olazanpine and the samidorphan after 15 minutes when thetablet is tested in 500 mL USP acetate buffer at pH 4.5 using a USPApparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpmand using a three-prong sinker.

In another embodiment, described herein is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering olanzapineand 10 mg of samidorphan together as a fixed dose, comprising: a firsttablet layer having 10 mg samidorphan, or a pharmaceutically acceptablesalt of samidorphan in an amount to deliver 10 mg samidorphan; and asecond tablet layer having 5 mg, 10 mg, 15 mg or 20 mg of olanzapine,and a film coating; wherein the tablet releases at least 85% of both theolazanpine and the samidorphan after 15 minutes or after 30 minutes whenthe tablet is tested in 500 mL 0.1N hydrochloric acid at pH 1.0 using aUSP Apparatus II (Paddle Method) at 37° C., with a paddle speed of 75rpm and using a three-prong sinker.

An exemplary preferred pharmaceutically acceptable coated immediaterelease bilayer tablet for orally delivering olanzapine and 10 mg or 20mg of samidorphan as a fixed dose is provided that includes: a firsttablet layer comprising: 10 mg or 20 mg samidorphan or apharmaceutically acceptable salt of samidorphan in an amount to deliver10 mg or 20 mg samidorphan; about 30-50 wt % microcrystalline cellulose,based on the weight of the first tablet layer; about 35-50 wt % lactoseor a hydrate thereof, based on the weight of the first tablet layer;optionally about 3.0 to about 7.0 wt % crospovidone; optionally about0.5 to about 1.5 wt % colloidal silica; and about 1.5 to about 2.5 wt %magnesium stearate; a second tablet layer comprising: a dose ofolanzapine selected from the group consisting of 2.5 mg, 5 mg, 10 mg, 15mg and 20 mg of the olanzapine; about 30-50 wt % microcrystallinecellulose, based on the weight of the second tablet layer; about 35-50wt % lactose monohydrate, based on the weight of the second tabletlayer; optionally about 3.0 to about 7.0 wt % crospovidone; optionallyabout 0.5 to about 1.5 wt % colloidal silica; and about 0.5 to about1.25 wt % magnesium stearate; and a film coating over the first andsecond tablet layer.

Another exemplary preferred tablet described herein is apharmaceutically acceptable coated immediate release bilayer tablet fororally delivering 5 mg olanzapine and 10 mg of samidorphan as a fixeddose, comprising: 5 mg olanzapine; 13.62 mg samidorphan L-malate; 60 mgmicrocrystalline cellulose; 65.88 mg lactose monohydrate; 2.5 mgcrospovidone; 0.75 mg colloidal silicon dioxide; 2.25 mg magnesiumstearate; and a film coating.

In one preferred embodiment, described herein is a pharmaceuticallyacceptable coated immediate release bilayer tablet for orally delivering10 mg olanzapine and 10 mg of samidorphan as a fixed dose, comprising:10 mg olanzapine; 13.62 mg samidorphan L-malate; 80 mg microcrystallinecellulose; 89.63 mg lactose monohydrate; 3.0 mg crospovidone; 1.0 mgcolloidal silicon dioxide; 2.75 mg magnesium stearate; and a filmcoating.

In another preferred embodiment, described herein is a pharmaceuticallyacceptable coated immediate release bilayer tablet for orally delivering15 mg olanzapine and 10 mg of samidorphan as a fixed dose, comprising:15 mg olanzapine; 13.62 mg samidorphan L-malate; 100 mg microcrystallinecellulose; 113.38 mg lactose monohydrate; 3.5 mg crospovidone; 1.25 mgcolloidal silicon dioxide; 3.25 mg magnesium stearate; and a filmcoating.

In another preferred embodiment, described herein is a pharmaceuticallyacceptable coated immediate release bilayer tablet for orally delivering20 mg olanzapine and 10 mg of samidorphan as a fixed dose, comprising:20 mg olanzapine; 13.62 mg samidorphan L-malate; 120 mg microcrystallinecellulose; 137.13 mg lactose monohydrate; 4.0 mg crospovidone; 1.5 mgcolloidal silicon dioxide; 3.75 mg magnesium stearate; and a filmcoating.

In another preferred embodiment, described herein is a pharmaceuticallyacceptable coated immediate release bilayer tablet for orally deliveringolanzapine and 20 mg of samidorphan as a fixed dose, comprising: a firsttablet layer comprising: 20 mg samidorphan or a pharmaceuticallyacceptable salt of samidorphan in an amount to deliver 20 mgsamidorphan; about 35-43 wt % microcrystalline cellulose, based on theweight of the first tablet layer; about 37-43 wt % lactose or a hydratethereof, based on the weight of the first tablet layer; and about 0.5 toabout 2 wt % magnesium stearate; a second tablet layer comprising: adose of olanzapine selected from the group consisting of 2.5 mg, 5 mg,10 mg, 15 mg and 20 mg of the olanzapine; about 38-42 wt %microcrystalline cellulose, based on the weight of the second tabletlayer; about 46-49 wt % lactose or a hydrate thereof, based on theweight of the second tablet layer; and about 0.5 to about 1.5 wt %magnesium stearate; and a film coating over the first and second tabletlayer.

In one embodiment, described herein is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering olanzapineand 10 mg of samidorphan as a fixed dose, comprising: a first tabletlayer comprising: 10 mg samidorphan or a pharmaceutically acceptablesalt of samidorphan in an amount to deliver 10 mg samidorphan; about35-43 wt % microcrystalline cellulose, based on the weight of the firsttablet layer; about 37-43 wt % lactose or a hydrate thereof, based onthe weight of the first tablet layer; and about 1.5 to about 2 wt %magnesium stearate; a second tablet layer comprising: a dose ofolanzapine selected from the group consisting of 5 mg, 10 mg, 15 mg and20 mg of the olanzapine; about 38-42 wt % microcrystalline cellulose,based on the weight of the second tablet layer; about 46-49 wt % lactoseor a hydrate thereof, based on the weight of the second tablet layer;and about 1.0 wt % magnesium stearate; and a film coating over the firstand second tablet layer; wherein the tablet releases at least 85% ofolazanpine and at least 85% of the samidorphan after 15 minutes when thetablet is tested in 500 mL USP acetate buffer at pH 4.5 using a USPApparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpmand using a three-prong sinker. In a preferred embodiment, olanzapineand samidorphan are released in in vitro testing at pH 1.0 and/or pH 4.5at substantially the same rate, meaning that the percentage ofolanzapine and samidorphan released at across all time points issubstantially similar, wherein “substantially” is defined to mean withinplus or minus 10%.

In another preferred embodiment, described herein is a tablet having anyof the characteristics described above, in which said tablet has a watercontent of no greater than about 10 wt % of the tablet, no greater thanabout 9.5 wt % of the tablet, no greater than about 9.0 wt % of thetablet, no greater than about 8.5 wt % of the tablet, no greater thanabout 8.0 wt % of the tablet, no greater than about 7.5 wt % of thetablet, no greater than about 7.0 wt % of the tablet, no greater thanabout 6.5 wt % of the tablet, no greater than about 6.0 wt % of thetablet, no greater than about 5.5 wt % of the tablet, no greater thanabout 5.0 wt % of the tablet, no greater than about 4.5 wt % of thetablet, no greater than about 4.0 wt % of the tablet, no greater thanabout 3.5 wt % of the tablet, no greater than about 3.0 wt % of thetablet, no greater than about 2.5 wt % of the tablet, no greater thanabout 2.0 wt % of the tablet, no greater than about 1.5 wt % of thetablet, no greater than about 1.0 wt % of the tablet, no greater thanabout 0.5 wt % of the tablet, or no greater than about 0.25 wt % of thetablet.

In another preferred embodiment, described herein is a tablet having anyof the characteristics described above, in which said tablet hasimpurities due to olanzapine degradation, samidorphan degradation, or acombination of samidorphan degradation and olanzapine degradation asdetected by HPLC, at 6 months, 9 months and/or 12 months or more ofstorage in a closed container at 25° C. and 60% relative humidity andoptionally containing silica gel desiccant, of between about 0.005 wt %and 5.0 wt %, 0.01 wt % and 3.0 wt %, 0.05% and 2.5 wt %, 0.1% and 2.0wt % and 0.1% to about 1.0 wt %, for example, this includes less thanabout 1.0 wt %, less than about 0.9 wt %, less than about 0.8 wt %, lessthan about 0.7 wt %, less than about 0.6 wt %, less than about 0.5 wt %,less than about 0.4 wt %, less than about 0.3 wt %, less than about 0.2wt %, less than about 0.1 wt %, less than about 0.09 wt %, less thanabout 0.08 wt %, less than about 0.07 wt %, less than about 0.06 wt %,less than about 0.05 wt %, less than about 0.04 wt %, less than about0.03 wt %, less than about 0.02 wt %, less than about 0.01 wt %.

Also described herein is a method of preparing a bilayer tablet for oraldelivery of olanzapine and samidorphan comprising preparing samidorphanL-malate in a particulate form having a particle size distribution (D10)of between about 10 μm and about 80 μm, a (D50) of between about 40 μmand about 200 μm and a (D90) of between about 100 μm and about 300 μm,more preferably a (D10) of between about 25 μm and about 50 μm, a (D50)of between about 60 μm and about 100 μm and a (D90) of between about 120μm and about 175 μm. The method further comprises preparing olanzapinehaving a particle size distribution (D10) of between 10 μm and 100 μm, aD(50) of between 50 μm and 150 μm and a D(90) of between 150 μm and 300μm, most preferably a D(10) of not less than 22 μm, a D(50) of between70 μm and 135 μm, and D(90) of not more than 284 μm. A larger particlesize distribution of the samidorphan and olanzapine results in a reduceddegradation of same due to the reduced surface area. It also reduces theimpact of degradation that each active has on the other. For instance, alarger particle size for samidorphan (and resultant reduction in surfacearea) will result in a reduced mutual degradation effect on theOlanzapine, caused by the samidorphan. However, an excessive increase inparticle size of either active ingredient can potentially give rise topoorer flow characteristics and tablet content uniformity. The aboveparticle size range has been observed to lead to reduced degradationwhilst at the same time maintaining acceptable flow characteristics forprocessing purposes.

The samidorphan L-malate particles are charged, along with colloidalsilicon dioxide into a first vessel and premixed to form a samidorphanpremix. Olanzapine, microcrystalline cellulose, crospovidone, andsilicon dioxide are charged into a second vessel and premixed to form anolanzapine premix. The samidorphan and olanzapine premixes arerespectively passed through a rotating impeller screening mill.Preferably, the mill has a screen with holes of between about 0.03 toabout 0.06 inches (0.762 mm to about 1.524 mm), most preferably betweenabout 0.045 to about 0.055 inches (about 1.14 mm to about 1.4 mm) indiameter. The samidorphan and olanzapine premixes are then blended inbin blenders to form a samidorphan blend and an olanzapine blend. Afirst and second quantity of magnesium stearate is passed through ascreen (most preferably having a hole size of about 350 to 500 microns,most preferably about 425 microns) and added to the samidorphan andolanzapine blends. The samidorphan and olanzapine blends are placed in atablet press to form a samidorphan and olanzapine blend layers. Theaforementioned blend layers are then compressed to form a bilayertablet. In one embodiment, the compressing of the samidorphan andolanzapine blend layers occurs at a force of between 0.4 kN-2 kN, whichensures an acceptable mechanical strength for the tablet whilst alsomaintaining the desired release characteristics for the samidorphan andolanzapine in the resultant tablet. The tablet is then coated byapplying an aqueous coating suspension to the tablet, and dried for aperiod of time sufficient such that the water content is less than 5.5wt % of the tablet. In one embodiment, the drying of the tablet mayfurther comprise selection of the exhaust temperature during coating(preferably maintaining in the range of 42 to 51° C., and mostpreferably in the range of 43 to 47° C.) and the inlet temperatureduring drying (preferably in the range of 70 to 80° C., most preferably75° C.) to aid in achieving the desired water content. Most preferably,a single olanzapine blend composition is used across multiple olanzapinestrengths (e.g. 2.5 mg, 5 mg, 10 mg, 15 mg or 20 mg) and the placing ofthe olanzapine blend into the tablet press includes selecting the weightof olanzapine blend based upon the desired dose of olanzapine in thebilayer tablet, rather than changing the olanzapine blend. Accordingly,a single olanzapine blend formulation can be used to produce multipleolanzapine dosage strengths, such as 2.5 mg, 5 mg, 10 mg, 15 mg or 20 mgof olanzapine which simplifies production of multiple strength tablets.Most preferably, the equipment required to carry out the method ishoused in an environment having an ambient temperature of no greaterthan 25° C. and an ambient relative humidity of no greater than 65%which aids in maintaining a low water content and low level ofdegradants in the resulting tablet. It is envisaged that such a methodcould be used to prepare any of the tablet formulations describedherein.

The bilayer tablets and associated methods for production and treatmentdescribed herein provide a robust solution to the problem of mutualdegradation between samidorphan and olanzapine when presented togetherin a single treatment. The described bilayer tablets provide for releaseof both actives at substantially the same rate, whilst ensuring that theformulation parameters used to achieve that objective result in amechanically stable tablet that is not prone to delamination between thesamidorphan and olanzapine layers. The blend formulation for olanzapineallows for a single formulation to be useful in creating tablets havingmultiple olanzapine strengths, and the method for production(particularly the control of the samidorphan and/or olanzapine particlesize and the drying of the tablet after coating) ensures that anydegradation of the samidorphan or olanzapine due to the ingress ofmoisture to the tablet is kept at a minimum. This results in a bilayertablet that is both physically and chemically stable over time, that issimple and convenient to manufacture and that releases olanzapine andsamidorphan at a substantially similar rate to ensure optimal deliveryof both active ingredients when dosed in vivo.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A depicts an exemplary dissolution profile overlay of olanzapinein Formulation A at pH 1, FIG. 1B depicts an exemplary dissolutionprofile overlay of samidorphan L-malate in Formulation A at pH 1, FIG.1C depicts an exemplary dissolution profile overlay of olanzapine inFormulation A at pH 4.5, FIG. 1D depicts an exemplary dissolutionprofile overlay of samidorphan L-malate in Formulation A at pH 4.5, FIG.1E depicts an exemplary dissolution profile overlay of olanzapine inFormulation A at pH 6.8, and FIG. 1F depicts an exemplary dissolutionprofile overlay of samidorphan L-malate in Formulation A at pH 6.8. InFIGS. 1A-1F, dose strengths shown refer to olanzapine dose/samidorphandose.

FIG. 2A depicts an exemplary dissolution profile overlay of olanzapinein Formulations B and C at pH 1, FIG. 2B depicts an exemplarydissolution profile overlay of samidorphan L-malate in Formulations Band C at pH 1, FIG. 2C depicts an exemplary dissolution profile overlayof olanzapine in Formulations B and C at pH 4.5, FIG. 2D depicts anexemplary dissolution profile overlay of samidorphan L-malate inFormulations B and C at pH 4.5, FIG. 2E depicts an exemplary dissolutionprofile overlay of olanzapine in Formulations B and C at pH 6.8, andFIG. 2F depicts an exemplary dissolution profile overlay of samidorphanL-malate in Formulations B and C at pH 6.8. In FIGS. 2A-2F, dosestrengths shown refer to olanzapine dose/samidorphan dose.

FIG. 3A depicts an exemplary dissolution profile overlay of olanzapinein Formulations B and A at pH 1. FIG. 3B depicts an exemplarydissolution profile overlay of samidorphan L-malate in Formulations Band A at pH 1. In FIGS. 3A-3B, dose strengths shown refer to olanzapinedose/samidorphan dose.

FIG. 4 depicts exemplary shelf life studies of olanzapine in disclosedtablets.

FIG. 5 depicts exemplary shelf life studies of samidorphan in disclosedtablets as represented by regression analyses.

FIG. 6 depicts exemplary shelf life studies of highest-related impurityamounts in disclosed tablets as represented by regression analyses.

FIG. 7 depicts exemplary shelf life studies of total-related impurityamounts in disclosed tablets as represented by regression analyses.

FIG. 8 depicts exemplary shelf life studies of olanzapine dissolution at30 minutes as represented by regression analyses.

FIG. 9 depicts exemplary shelf life studies of samidorphan dissolutionat 30 minutes as represented by regression analyses.

FIG. 10 depicts exemplary shelf life studies of water content indisclosed tablets as represented by regression analyses.

FIG. 11 depicts mean (and standard deviation) plasma concentrations ofolanzapine as observed on Day 14 of the pharmacokinetic population study(titled Clinical Study 1) described in Example 7 herein.

FIG. 12 depicts mean (and standard deviation) plasma concentrations ofsamidorphan as observed on Day 14 of the pharmacokinetic populationstudy (titled Clinical Study 1) described in Example 7 herein.

FIG. 13 depicts mean (and standard deviation) plasma concentrations ofolanzapine as observed in the pharmacokinetic population study (titledClinical Study 2) described in Example 8 herein.

FIG. 14 depicts a dissolution profile overlay of samidorphan L-malateoverlaid with the dissolution profile of olanzapine obtained forFormulation A (10/10) at pH 4.5.

DETAILED DESCRIPTION

The features and other details of the disclosure will now be moreparticularly described. Before further description of the presentdisclosure, certain terms employed in the specification, examples andappended claims are collected here. These definitions should be read inlight of the remainder of the disclosure and as understood by a personof skill in the art. Unless defined otherwise, all technical andscientific terms used herein have the same meaning as commonlyunderstood by a person of ordinary skill in the art.

Definitions

As used herein, the term “about” will be understood by persons ofordinary skill in the art and will vary to some extent on the context inwhich it is used. As used herein when referring to a measurable valuesuch as an amount, a temporal duration, and the like, the term “about”is meant to encompass variations of ±10%, including±5%, ±1%, and ±0.1%from the specified value, as such variations are appropriate to performthe disclosed methods.

“Individual,” “patient,” or “subject” are used interchangeably hereinand include any animal, including mammals, including mice, rats, otherrodents, rabbits, dogs, cats, swine, cattle, sheep, horses, or primates,and humans. The compounds described herein can be administered to amammal, such as a human, but can also be administered to other mammalssuch as an animal in need of veterinary treatment, e.g., domesticanimals (e.g., dogs, cats, and the like), farm animals (e.g., cows,sheep, pigs, horses, and the like) and laboratory animals (e.g., rats,mice, guinea pigs, and the like). The mammal treated in the methodsdescribed herein is desirably a mammal in which treatment of a disorderdescribed herein is desired, such as a human.

As used herein, “pharmaceutically acceptable” includes molecularentities and compositions that do not produce an adverse, allergic orother untoward reaction when administered to an animal, or a human, asappropriate. For human administration, preparations should meetsterility, pyrogenicity, and general safety and purity standards asrequired by FDA Office of Biologics standards.

The term “pharmaceutically acceptable salt(s)” as used herein refers tosalts of acidic or basic groups that may be present in compounds used inthe compositions. Compounds included in the present compositions thatare basic in nature are capable of forming a wide variety of salts withvarious inorganic and organic acids. The acids that may be used toprepare pharmaceutically acceptable acid addition salts of such basiccompounds are those that form non-toxic acid addition salts, i.e., saltscontaining pharmacologically acceptable anions, including, but notlimited to, malate (e.g., L-malate), oxalate, chloride, bromide, iodide,nitrate, sulfate, bisulfate, phosphate, acid phosphate, isonicotinate,acetate, lactate, salicylate, citrate, tartrate, oleate, tannate,pantothenate, bitartrate, ascorbate, succinate, maleate, gentisinate,fumarate, gluconate, glucaronate, saccharate, formate, benzoate,glutamate, methanesulfonate, ethanesulfonate, benzenesulfonate,p-toluenesulfonate and pamoate (i.e.,1,1′-methylene-bis-(2-hydroxy-3-naphthoate)) salts.

As used herein, “treating” includes any effect, e.g., lessening,reducing, modulating, or eliminating, that results in the improvement ofthe condition, disease, disorder and the like.

As used herein, “wt %” means weight percent.

Tablets

This disclosure in part provides for a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering olanzapineand samidorphan (e.g., 5 mg, 10 mg, 15 mg, 20 mg), together as a fixeddose, comprising: a first tablet layer having samidorphan orpharmaceutically acceptable salt thereof (e.g., 10 mg samidorphan, or apharmaceutically acceptable salt of samidorphan in an amount to deliver10 mg samidorphan); and a second tablet layer having olanzapine (e.g.,2.5 mg, 5 mg, 10 mg, 15 mg or 20 mg of olanzapine), and a film coating;wherein the tablet releases at least 85% of both the olazanpine and thesamidorphan after 15 minutes when the tablet is tested in 500 mL 0.1Nhydrochloric acid at pH 1.0 using a USP Apparatus II (Paddle Method) at37° C., with a paddle speed of 75 rpm and using a three-prong sinker.Such contemplated tablets may have less than or about 0.1% wt % to about1.0 wt %, e.g., about 0.5 wt % or less of impurities due to olanzapineor samidorphan degradation as detected by HPLC, at 6 months, 9 monthsand/or 12 months or more of storage in a closed container (e.g., acontainer at 25° C. and 60% relative humidity and optionally containingsilica gel desiccant.) Such contemplated tablets may further comprisepharmaceutically acceptable excipients such as: diluents, glidants,disintegrants and lubricants, which may be present separately in anylayer or layers of the multi-layer tablets.

For example, a first tablet layer may further comprise: about 75-90 wt %of a first diluent, based on the weight of the first tablet layer; afirst glidant; a first disintegrant; and a first lubricant. In someembodiments, a second tablet layer further comprises: about 75-90 wt %of a second diluent; based on the weight of the second tablet layer; asecond glidant; a second disintegrant; and a second lubricant. The firstand second diluent may be the same or may be different, and for example,the first and second diluent may each independently selected from thegroup consisting of lactose or a hydrate thereof, microcrystallinecellulose, mannitol, sorbitol, xylitol, dicalcium phosphate, starch, andcombinations thereof.

The first and second lubricant may be for example, each independentlyselected from the group consisting of a pharmaceutically acceptable saltof a stearate, stearic acid, or a combination thereof, and the first andsecond disintegrant may each independently selected from the groupconsisting of polyvinylpyrrolidone (crospovidone), crosslinked sodiumcarboxymethyl cellulose (croscarmellose sodium), sodium starch glycolateand combinations thereof. The first and second glidant may be, forexample, each independently selected from the group consisting ofsilicon dioxide, talc, a carbonate salt and combinations thereof.

Contemplated pharmaceutically acceptable coated immediate releasebilayer tablets can include 2.5 mg olanzapine, 5 mg olanzapine, 10 mgolanzapine, or 15 mg olanzapine. In some embodiments, thepharmaceutically acceptable coated immediate release bilayer tabletcomprises 20 mg olanzapine. For example, a second tablet layer may have5 mg, 10 mg, 15 mg or 20 mg olanzapine.

Provided herein, for example, is a pharmaceutically acceptable coatedimmediate release bilayer tablet for orally delivering olanzapine andsamdorphan as a fixed dose, for example, a tablet that can provide to apatient 10 mg samidorphan and 2.5 mg olanzapine, or provide to a patient10 mg samidorphan and 5 mg olanzapine, 10 mg samidorphan and 10 mgolanzapine, 10 mg samidorphan and 15 mg olanzapine, or 10 mg samidorphanand 20 mg olanzapine. For example, provided here is a fixed dose tabletcomprising: a first tablet layer comprising: 10 mg samidorphan, or apharmaceutically acceptable salt of samidorphan in an amount to deliver10 mg samidorphan; about 35-43 wt % microcrystalline cellulose, based onthe weight of the first tablet layer; about 37-43 wt % lactose or ahydrate thereof, based on the weight of the first tablet layer; andabout 1.5 to about 2 wt % magnesium stearate; a second tablet layercomprising: a dose of olanzapine selected from the group consisting of 5mg, 10 mg, 15 mg and 20 mg of the olanzapine; about 38-42 wt %microcrystalline cellulose, based on the weight of the second tabletlayer; about 46-49 wt % lactose or a hydrate thereof, based on theweight of the second tablet layer; and about 1.0 wt % magnesiumstearate; and a film coating over the first and second tablet layer.

In another embodiment, described herein is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering 5 mg, 10mg, 15 mg or 20 mg olanzapine, together with 10 mg of samidorphan as afixed dose, comprising: a first tablet layer comprising: 13.6 mgsamidorphan L-malate; about 40 wt % microcrystalline cellulose, based onthe weight of the first tablet layer; about 42 wt % lactose monohydrate,based on the weight of the first tablet layer; and about 1.75 wt %magnesium stearate; a second tablet layer comprising: a dose ofolanzapine selected from the group consisting of 5 mg, 10 mg, 15 mg and20 mg of the olanzapine; about 40 wt % microcrystalline cellulose, basedon the weight of the second tablet layer; about 47 wt % lactose or ahydrate thereof, based on the weight of the second tablet layer; andabout 1.0 wt % magnesium stearate; and a film coating over the first andsecond tablet layer.

In another embodiment, described herein is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering olanzapineand about 10 mg of samidorphan as a fixed dose, comprising: a firsttablet layer comprising: about 10 mg samidorphan or a pharmaceuticallyacceptable salt of samidorphan in an amount to deliver about 10 mgsamidorphan; about 30-45 wt % microcrystalline cellulose, based on theweight of the first tablet layer; about 35-50 wt % lactose or a hydratethereof, based on the weight of the first tablet layer; and about 0.5 toabout 2 wt % magnesium stearate; a second tablet layer comprising: adose of olanzapine of between 2.5 mg and about 20 mg; about 35-45 wt %microcrystalline cellulose, based on the weight of the second tabletlayer; about 45-55 wt % lactose or a hydrate thereof, based on theweight of the second tablet layer; and about 1.0 wt % magnesiumstearate; and a film coating over the first and second tablet layer.

The particle size distribution of the samidorphan or samidorphanpharmaceutically acceptable salt (e.g., L-malate) present in a disclosedtablet (e.g., as part of a first tablet layer) may be for example, a(D10) of between about 10 μm to about 80 μm, a (D50) of between about 40μm to about 200 μm and a (D90) of between about 100 μm to about 300 μm,more preferably a D10 of between about 25 μm and about 50 μm; the D50 ofbetween about 60 μm and about 100 μm. In some embodiments, D90 of thesamidorphan (e.g., L-malate salt) is between about 120 μm and about 175μm. The particle size distribution of the olanzapine may include, forexample a (D10) of between 10 μm and 100 μm, a D(50) of between 50 μmand 150 μm and a D(90) of between 150 μm and 300 μm, most preferably aD(10) of not less than 22 μm, a D(50) of between 70 μm and 135 μm, andD(90) of not more than 284 μm. Particle size (diameter) may bedetermined by conventional techniques such as dynamic light scattering.The ‘Dx’ nomenclature means that ‘x’ percent of the particles have anumber average diameter (‘D’) less than or equal to the reported valuewhen measured by static or dynamic light scattering techniques known tothose skilled in the art. (e.g. D10=175 μm, means that 10% of particleshave a number average diameter of less than or equal to 175 μm), a D50(or Dv50) of less than 300 μm, means that 50% of the particle populationhas a diameter of less than or equal to 300 μm. The term “Dx” as usedherein refers to a volume based size and is equivalent to the term “DvX”commonly used to characterize particle sizes. Since the particles of thepresent invention may be irregular in shape, an approximation of theparticle size is made on the basis of the volume-based particle size,which specifies the diameter of the sphere that has same volume as agiven particle. Unless otherwise specified, all particle sizes arespecified in terms of volume-based measurements and are measured bylaser light scattering/diffraction. Particle sizes are then determinedbased on Mie scattering theory.

A disclosed exemplary tablet, in an embodiment, releases at least 85% ofolanzapine and at least 85% of the samidorphan after 15 minutes when thetablet is tested in 500 mL USP acetate buffer at pH 4.5 using a USPApparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpmand using a three-prong sinker. In some embodiments, a disclosed tabletreleases at least 97% of olanzapine and at least 97% of the samidorphanafter 30 minutes when the tablet is tested in 500 mL USP acetate bufferat pH 4.5 using a USP Apparatus II (Paddle Method) at 37° C., with apaddle speed of 75 rpm.

Minimal impurities in a disclosed tablet may be present, for example,less than 0.1 wt % impurities, less than 0.5 wt % impurities, e.g., lessthan 1.0 wt % impurities, from olanzapine degradation, are detected,using HPLC, after the tablet is stored for 3 months, 6 months, or e.g.,9 months, in a closed container containing 250 g silica gel desiccant at25° C. and 60% relative humidity. In some embodiments, the tablet has0.5 wt % or fewer impurities (or e.g., 1.0 wt % or less impurities) dueto the olanzapine or the samidorphan degradation as detected by HPLC, at6 months of storage in a blister pack at 25° C. and 60% relativehumidity.

An exemplary first tablet layer may further comprise about 2.0 wt %crospovidone, and/or about 0.5 wt % silicon dioxide. and/or. In someembodiments, the second tablet layer may include about 1.0 wt %crospovidone and/or 0.5 wt % silicon dioxide

Contemplated film coatings for the disclosed tablets may include anOpadry II 33K film coat. In some embodiments, the pharmaceuticallyacceptable coated immediate release bilayer tablet comprises 2.5 mgolanzapine. In some embodiments, the pharmaceutically acceptable coatedimmediate release bilayer tablet comprises 5 mg olanzapine. In someembodiments, the pharmaceutically acceptable coated immediate releasebilayer tablet comprises 10 mg olanzapine. In some embodiments, thepharmaceutically acceptable coated immediate release bilayer tabletcomprises 15 mg olanzapine. In some embodiments, the pharmaceuticallyacceptable coated immediate release bilayer tablet comprises 20 mgolanzapine.

In a preferred embodiment, described herein is a pharmaceuticallyacceptable coated immediate release bilayer tablet for orally deliveringolanzapine and 10 mg of samidorphan together as a fixed dose,comprising: a first tablet layer having 10 mg samidorphan, or apharmaceutically acceptable salt of samidorphan in an amount to deliver10 mg samidorphan; and a second tablet layer having 2.5 mg, 5 mg, 10 mg,15 mg or 20 mg of olanzapine, and a film coating; wherein the tabletreleases at least 80% of both the olazanpine and the samidorphan after15 minutes when the tablet is tested in 500 mL USP acetate buffer at pH4.5 using a USP Apparatus II (Paddle Method) at 37° C., with a paddlespeed of 75 rpm and using a three-prong sinker.

In another preferred embodiment, a pharmaceutically acceptable coatedimmediate release bilayer tablet for orally delivering olanzapine and 10mg or 20 mg of samidorphan as a fixed dose, comprises: a first tabletlayer comprising: 10 mg or 20 mg samidorphan or a pharmaceuticallyacceptable salt of samidorphan in an amount to deliver 10 mg or 20 mgsamidorphan; about 30-50 wt % microcrystalline cellulose, based on theweight of the first tablet layer; about 35-50 wt % lactose or a hydratethereof, based on the weight of the first tablet layer; optionally about3.0 to about 7.0 wt % crospovidone; optionally about 0.5 to about 1.5 wt% colloidal silica; and about 1.5 to about 2.5 wt % magnesium stearate;a second tablet layer comprising: a dose of olanzapine selected from thegroup consisting of 2.5 mg, 5 mg, 10 mg, 15 mg and 20 mg of theolanzapine; about 30-50 wt % microcrystalline cellulose, based on theweight of the second tablet layer; about 35-50 wt % lactose monohydrate,based on the weight of the second tablet layer; optionally about 3.0 toabout 7.0 wt % crospovidone; optionally about 0.5 to about 1.5 wt %colloidal silica; and about 0.5 to about 1.25 wt % magnesium stearate;and a film coating over the first and second tablet layer.

Also contemplated by this disclosure is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering 5 mgolanzapine and 10 mg of samidorphan as a fixed dose, comprising: 5 mgolanzapine; 13.62 mg samidorphan L-malate; 60 mg microcrystallinecellulose; 65.88 mg lactose monohydrate; 2.5 mg crospovidone; 0.75 mgcolloidal silicon dioxide; 2.25 mg magnesium stearate; and a filmcoating.

In one embodiment, described herein is a pharmaceutically acceptablecoated immediate release bilayer tablet for orally delivering 10 mgolanzapine and 10 mg of samidorphan as a fixed dose, comprising: 10 mgolanzapine; 13.62 mg samidorphan L-malate; 80 mg microcrystallinecellulose; 89.63 mg lactose monohydrate; 3.0 mg crospovidone; 1.0 mgcolloidal silicon dioxide; 2.75 mg magnesium stearate; and a filmcoating.

A pharmaceutically acceptable coated immediate release bilayer tabletfor orally delivering 15 mg olanzapine and 10 mg of samidorphan as afixed dose, comprising: 15 mg olanzapine; 13.62 mg samidorphan L-malate;100 mg microcrystalline cellulose; 113.38 mg lactose monohydrate; 3.5 mgcrospovidone; 1.25 mg colloidal silicon dioxide; 3.25 mg magnesiumstearate; and a film coating is also contemplated.

Described herein in part is a pharmaceutically acceptable coatedimmediate release bilayer tablet for orally delivering 20 mg olanzapineand 10 mg of samidorphan as a fixed dose, comprising: 20 mg olanzapine;13.62 mg samidorphan L-malate; 120 mg microcrystalline cellulose; 137.13mg lactose monohydrate; 4.0 mg crospovidone; 1.5 mg colloidal silicondioxide; 3.75 mg magnesium stearate; and a film coating.

Further described herein is a pharmaceutically acceptable coatedimmediate release bilayer tablet for orally delivering olanzapine and 20mg of samidorphan as a fixed dose, comprising: a first tablet layercomprising: 20 mg samidorphan or a pharmaceutically acceptable salt ofsamidorphan in an amount to deliver 20 mg samidorphan; about 35-43 wt %microcrystalline cellulose, based on the weight of the first tabletlayer; about 37-43 wt % lactose or a hydrate thereof, based on theweight of the first tablet layer; and about 0.5 to about 2 wt %magnesium stearate; a second tablet layer comprising: a dose ofolanzapine selected from the group consisting of 2.5 mg, 5 mg, 10 mg, 15mg and 20 mg of the olanzapine; about 38-42 wt % microcrystallinecellulose, based on the weight of the second tablet layer; about 46-49wt % lactose or a hydrate thereof, based on the weight of the secondtablet layer; and about 0.5 to about 1.5 wt % magnesium stearate; and afilm coating over the first and second tablet layer.

A pharmaceutically acceptable coated immediate release bilayer tabletfor orally delivering olanzapine and 10 mg of samidorphan as a fixeddose is also provided, comprising: a first tablet layer comprising: 10mg samidorphan or a pharmaceutically acceptable salt of samidorphan inan amount to deliver 10 mg samidorphan; about 35-43 wt %microcrystalline cellulose, based on the weight of the first tabletlayer; about 37-43 wt % lactose or a hydrate thereof, based on theweight of the first tablet layer; and about 1.5 to about 2 wt %magnesium stearate; a second tablet layer comprising: a dose ofolanzapine selected from the group consisting of 5 mg, 10 mg, 15 mg and20 mg of the olanzapine; about 38-42 wt % microcrystalline cellulose,based on the weight of the second tablet layer; about 46-49 wt % lactoseor a hydrate thereof, based on the weight of the second tablet layer;and about 1.0 wt % magnesium stearate; and a film coating over the firstand second tablet layer; wherein the tablet releases at least 85% ofolazanpine and at least 85% of the samidorphan after 15 minutes when thetablet is tested in 500 mL USP acetate buffer at pH 4.5 using a USPApparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpmand using a three-prong sinker.

Preferably the bilayer tables are manufactured by compressing separateblends, one containing olanzapine and the other containing samidorphanL-malate, into bilayer tablets. It is most preferable if the samesamidorphan and olanzapine blends are used for multiple tabletstrengths, with only the olanzapine blend weight being adjusted toachieve the required olanzapine dose in the tablet and the samidorphanblend weight being kept constant. As a result of this formulationapproach, it is possible to prepare, for example, a bilayer tablet fordelivering 5 mg of olanzapine and 10 mg of samidorphan (5/10), 10 mg ofolanzapine and 10 mg of samidorphan (10/10), 15 mg of olanzapine and 10mg of samidorphan (15/10) and 20 mg of olanzapine and 10 mg ofsamidorphan (20/10) dose strengths. The advantage that this formulationapproach offers is that it allows the same olanzapine and samidorphanblends to be used to create different olanzapine strength compositions,without the need to adjust the components or their respective quantitiesof the olanzapine blend layer.

Methods of Treatment

Also contemplated herein is a method of treating a patient sufferingfrom a mental illness, comprising administering to the patient atherapeutically effective amount of olanzapine and samidorphan as one ormore tablets described herein (e.g., an immediate release bilayer tabletdescribed herein). Contemplated mental illness may be selected from thegroup consisting of schizophreniform disorder, schizoaffective disorder,severe schizoaffective disorder with psychotic features, bipolar Idisorders with a single manic episode, severe bipolar I disorders withpsychotic features, bipolar I disorders manifesting a mixed most recentepisode, severe bipolar I disorders with psychotic features, briefpsychotic disorders, psychotic disorders NOS, paranoid personalitydisorders, schizoid personality disorders, schizophrenia, schizotypalpersonality disorders with sedative, hypnotic, or anxiolyticmanifestations, major depressive disorders with psychotic features,dementia, acute mania, psychotic agitation, unipolar disorder, andpsychotic disorders due to specific general medical conditions. In someembodiments, the tablet is orally administered to the patient.

In some embodiments, the mental illness is a selected from the groupconsisting of schizophreniform disorder, schizoaffective disorder,severe schizoaffective disorder with psychotic features, bipolar Idisorders with a single manic episode, severe bipolar I disorders withpsychotic features, bipolar I disorders manifesting a mixed most recentepisode, severe bipolar I disorders with psychotic features, briefpsychotic disorders, psychotic disorders NOS, paranoid personalitydisorders, schizoid personality disorders, schizophrenia, schizotypalpersonality disorders with sedative, hypnotic, or anxiolyticmanifestations, major depressive disorders with psychotic features,dementia, acute mania, psychotic agitation, unipolar disorder, andpsychotic disorders due to specific general medical conditions.

For example, provided herein is a method of treating schizophrenia orbipolar disorder I, e.g., in adults and/or children in need thereof,comprising administering to the adult or child once daily a disclosedtablet, for example, a disclosed tablet having 10 mg samidorphan and 5mg, 10 mg, 15 mg or 20 mg olanzapine.

Also provided herein is a method of treating bipolar disorder I, e.g.,in adults and/or children in need thereof, comprising administering tothe adult or child once daily a disclosed tablet, for example, adisclosed tablet having 10 mg samidorphan and 5 mg, 10 mg, 15 mg or 20mg olanzapine. For example, provided herein is a method of acutelytreating manic and mixed episodes of bipolar disorder I, or a method ofmaintaining monotherapy treatment in a patient suffering from bipolardisorder I, comprising administering to the adult or child once daily adisclosed tablet, for example, a disclosed tablet having 10 mgsamidorphan and 2.5 mg, 5 mg, 10 mg, 15 mg or 20 mg olanzapine.

Provided herein, in another embodiment, is a method of manic or mixedepisodes of bipolar disorder I, e.g., in an adult patient and/orpediatric patient in need thereof, wherein the patient is alsoadministered an adjunct treatment of valproate or lithium, comprisingadministering to the patient once daily a disclosed tablet, for example,a disclosed tablet having 10 mg samidorphan and 2.5 mg, 5 mg, 10 mg, 15mg or 20 mg olanzapine.

Kits

Also provided herein are kits for use, (e.g., for use in the methods oftreatment described herein), comprising a tablet described herein (e.g.,an immediate release bilayer tablet described herein). Such kits includea suitable dosage form such as those described above and instructionsdescribing the method of using such dosage form to mediate, reduce orprevent inflammation. The instructions would direct the consumer ormedical personnel to administer the dosage form according toadministration modes known to those skilled in the art. Such kits couldadvantageously be packaged and sold in single or multiple kit units. Anexample of such a kit is a so-called blister pack. Blister packs arewell known in the packaging industry and are being widely used for thepackaging of pharmaceutical unit dosage forms (tablets, capsules, andthe like). Blister packs generally consist of a sheet of relativelystiff material covered with a foil of a preferably transparent plasticmaterial. During the packaging process recesses are formed in theplastic foil. The recesses have the size and shape of the tablets to bepacked. Next, the tablets are placed in the recesses and the sheet ofrelatively stiff material is sealed against the plastic foil at the faceof the foil which is opposite from the direction in which the recesseswere formed. As a result, the tablets are sealed in the recesses betweenthe plastic foil and the sheet. Preferably the strength of the sheet issuch that the tablets can be removed from the blister pack by manuallyapplying pressure on the recesses whereby an opening is formed in thesheet at the place of the recess. The tablet can then be removed viasaid opening.

Examples

Abbreviations: SAM: samidorphan; OLZ: olanzapine; RH: relative humidity;HPLC: high performance liquid chromatography; rpm: revolutions perminute; USP: United States Pharmacopeia; LOQ: limit of quantification.

Example 1. Incompatibility of Olanzapine and Samidorphan

The chemical compatibility between olanzapine form I and samidorphanL-malate was determined by grinding the two drug substances togetherwith a mortar and pestle and placing then on stability at 40° C./75% RHin open and closed vial configurations. Chemical incompatibility wasobserved between olanzapine and samidorphan L-malate. as olanzapine issusceptible to increased degradation in the presence of samidorphanL-malate, which is further increased with higher exposure to humidity.

Samples in 20 ml Wheaton scintillation vials were stored at 40° C./75%RH in open and closed vial configurations. Closed vials were vialsclosed with a urea cap and wrapped using parafilm under ambientconditions. The contents of the vials were tested at the start of thestudy and after 2, 6 and 12 weeks. At each time point samples wereanalysed by reversed phase HPLC (Waters ACQUITY UPLC H-Class System)with ACQUITY PDA Detector using a Waters ACQUITY UPLC CSH C18 Column, 3mm×100 mm, and a gradient elution of acetate buffer pH 5.1 and 50/50(v/v) acetonitrile/methanol. Detection of olanzapine was performed at260 nm and samidorphan at 305 nm. The olanzapine/samidorphan mix sampleswere analyzed in duplicate and the average results were reported. Theresults for the olanzapine and samidorphan L-malate chemical stabilityare reported as percent total impurities in Table 1. Olanzapine relatedcompound B was the major impurity observed and percent level is reportedin Table 2.

TABLE 1 Percentage Total Impurities of Olanzapine and Samidorphan at 40°C./75 RH OPEN CLOSED SAM- INI- 2 6 12 2 6 12 PLE TIAL WEEK WEEK WEEKWEEK WEEK WEEK OLZ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 SAM 0.00 0.00 0.000.00 0.00 0.00 0.00 OLZ + 0.00 0.05 0.22 0.84 0.00 0.12 0.48 SAM

TABLE 2 Percentage Related Compound B Impurity 40° C./75% RH OPEN CLOSEDSAM- INI- 2 6 12 2 6 12 PLE TIAL WEEK WEEK WEEK WEEK WEEK WEEK OLZ 0.01<LOQ ND ND ND ND ND OLZ + 0.02 0.05 0.22 0.79 <LOQ 0.12 0.33 SAM ND:≤LOD (0.02 wt %), LOQ: 0.05 wt %

Results from the chemical compatibility analysis by HPLC show that therewas no significant level of any related impurity above the LOQ in eitherthe olanzapine or samidorphan L-malate drug substance, when storedseparately. The highest level of related impurities was detected in thedrug substance mixture, with olanzapine related compound B as the majordegradant detected and no samidorphan related impurities detected. Thedata therefore shows that olanzapine is susceptible to increaseddegradation in the presence of samidorphan L-malate thus making themchemically incompatible. The levels for the olanzapine related impurityin the open vial are higher than in the closed vial condition due to theincreased hydrolysis of the olanzapine at 40° C./75% RH.

Example 2. Exemplary Manufacturing Process of a Bilayer Tablet for OralDelivery of Olanzapine and Samidorphan

An exemplary manufacturing process for a bilayer tablet for oraldelivery of olanzapine and samidorphan using two direct compressionblends, one containing olanzapine and the other containing samidorphanL-malate, which are compressed into bilayer tablets, is described below.

Step 1—Dispensing: All materials for manufacturing bilayer tablets aredispensed.

Step 2—Samidorphan-Colloidal Silicon Dioxide Premix: SamidorphanL-malate and colloidal silicon dioxide are charged into a vessel andpremixed.

Step 3—Charging and Material Delumping: Materials for an olanzapineblend (olanzapine, microcrystalline cellulose, crospovidone, and silicondioxide) are charged into an Intermediate Bulk Container (IBC), andmaterials for the samidorphan L-malate blend (samidorphan L-malate andcolloidal silicon dioxide premix, microcrystalline cellulose, lactosemonohydrate, and crospovidone) are charged into a separate IBC, in anorder to facilitate layering of the drug substance between excipientlayers. Separately, each IBC is docked above a rotating impellerscreening mill. The screening mill is equipped with a screen with holes0.045-0.055 inches (1.14 mm to about 1.4 mm) in diameter. The speed isset to achieve the desired material throughput. Independently, thematerials are passed through the mill and collected into separate IBCs.

Step 4—Main Blending: Next, for each blend, the IBC is docked to adiffusion bin blender (tumble) and the materials are blended for adefined time at a fixed speed.

Step 5—Lubrication Blending: Next, magnesium stearate is sieved througha 425 micron (40 mesh) hand screen and added to the IBC for each blend.For each blend, the IBC is docked to a diffusion bin blender (tumble)and the blend is lubricated for a defined time at a fixed speed.

Step 6—Compression: Next, lubricated blends are gravity-fed to thetablet press hoppers from both IBCs. A power-assisted rotary tabletpress is set up with appropriate tablet tooling, a tablet deduster, anda metal detector. During tablet compression, checks are performed on thefirst layer tablet weight, bilayer tablet weight, and thickness atdefined intervals. Fill depth and compression force are monitored andadjusted to achieve in-process control acceptance criteria. Appropriatecontrol over the aforementioned variables ensures that the desiredrelease characteristics for the tablet are achieved.

Step 7—Coating and Drying: Next, the OPADRY® II aqueous coatingsuspension is used to apply a cosmetic film coating to the tablets. Thecoating process is performed in a fully perforated coating pan toachieve the target weight gain. The coated tablets are dried to aspecified loss-on-drying (LOD) value. Control of tablet water content isachieved through careful control of the exhaust temperature duringcoating and the inlet temperature during drying. After coating anddrying, samples are removed for quality control release testing of thebulk finished product.

Step 8—Bulk Packaging: Tablets are discharged from the coater into ahigh-density polyethylene (HDPE) drum lined with two low-densitypolyethylene (LDPE) bags, with desiccant between the bags, and stored atcontrolled room temperature.

Step 9: Weight Sorting and Bulk Repackaging: The coated tablets aresorted by weight to remove delaminated and broken tablets. Theacceptable tablets are repackaged into a 75L HDPE drum lined with two(2) LDPE bags, with desiccant between the bags, and stored at controlledroom temperature.

Step 10: The coated tablets are packaged into bottles. Silica geldesiccant is added to the bottle to control moisture and ensurestability over shelf life. Control of water permeation into thepackaging of the product over its shelf life is an essential step toachieve target purity. This is controlled through the use of desiccantand an induction seal on the bottle. Sealing controlled by the hoodheight, induction sealing power and line speed.

Example 3. Tablet Formulations

Immediate release bilayer tablet formulations of olanzapine andsamidorphan L-malate were prepared. Depending on the strength, threediscrete variations in formulation (defined as Formulations A through C)have been manufactured. A comparison of compositions for olanzapine andsamidorphan L-malate formulation variations by individual tabletstrengths is provided in Table 3, Table 4, Table 5, Table 6 and Table 7respectively. A comparison of the compositions of olanzapine andsamidorphan blends for formulation variations is provided in Table 8,Table 9 and Table 10 respectively.

Referring to Formulation A, for example and the various olanzapinestrength compositions shown in tables 3-7, bilayer tablets weremanufactured by compressing separate blends, one containing olanzapineand the other containing samidorphan L-malate, into bilayer tablets. Thesame components are used for all tablet strengths, with the olanzapineblend weight adjusted based on tablet strength and the samidorphan blendweight kept constant, resulting in tablets which delivered 10 mg ofsamidorphan and 2.5 mg, 5 mg, 10 mg, 15 mg and 20 mg of olanzapinerespectively. This allowed the same olanzapine and samidorphan blends tobe used to create different olanzapine strength compositions.

TABLE 3 2.5 mg Olanzapine/10 mg Samidorphan Tablet Composition Amount(mg) Amount (% wt) Component per tablet per coated tablet Olanzapine 2.51.67 Samidorphan L-malate 13.62 9.08 Microcrystalline cellulose, NF61.14 40.76 Lactose monohydrate, NF 67.24 44.83 Crospovidone, NF 2.501.67 Colloidal silicon dioxide, NF 0.75 0.5 Magnesium stearate, NF 2.251.5 Total uncoated tablet 150.00 100

TABLE 4 5 mg Olanzapine/10 mg Samidorphan Tablet Composition Amount (mg)Amount (% wt) per per tablet coated tablet Component Formulation AOlanzapine 5.00 3.21 Samidorphan L-malate 13.62 8.73 Microcrystallinecellulose, NF 60.00 38.46 Lactose monohydrate, NF 65.88 42.23Crospovidone, NF 2.50 1.60 Colloidal silicon dioxide, NF 0.75 0.48Magnesium stearate, NF 2.25 1.44 Total uncoated tablet 150.00 — Filmcoat suspension Opadry ® II yellow 33K120005 6.00 3.85 Total coatedtablet 156.00 100.00

TABLE 5 10 mg Olanzapine/10 mg Samidorphan Tablet Compositions AmountAmount Amount Amount (% wt) per Amount (% wt) per Amount (% wt) per (mg)per coated (mg) per coated (mg) per coated tablet tablet tablet tablettablet tablet Component Formulation A Formulation B Formulation COlanzapine 10.00 4.81 10.00 4.81 9.95 4.78 Samidorphan L-malate 13.626.55 13.62 6.55 13.55 6.51 Microcrystalline cellulose, NF 80.00 38.4680.00 38.46 79.60 38.27 Lactose monohydrate, NF 89.63 43.09 90.38 43.4589.93 43.24 Crospovidone, NF 3.00 1.44 3.00 1.44 2.99 1.44 Colloidalsilicon dioxide, NF 1.00 0.48 1.00 0.48 1.99 0.96 Magnesium stearate, NF2.75 1.32 2.00 0.96 1.99 0.96 Total uncoated tablet 200.00 200.00 200.00Film coat suspension Opadry ® II orange 33K130001 8.00 3.85 8.00 3.858.00 3.85 Total coated tablet 208.00 100.00 208.00 100.00 208.00 100.00

TABLE 6 15 mg Olanzapine/10 mg Samidorphan Tablet Compositions AmountAmount Amount (% wt) per Amount (% wt) per (mg) per coated (mg) percoated tablet tablet tablet tablet Component Formulation A Formulation BOlanzapine 15.00 5.77 15.00 5.77 Samidorphan L-malate 13.62 5.24 13.625.24 Microcrystalline 100.00 38.46 100.00 38.46 cellulose, NF Lactosemonohydrate, 113.38 43.61 114.13 43.90 NF Crospovidone, NF 3.50 1.353.50 1.35 Colloidal silicon 1.25 0.48 1.25 0.48 dioxide, NF Magnesiumstearate, NF 3.25 1.25 2.50 0.96 Total uncoated tablet 250.00 250.00Film coat suspension Opadry ® II blue 10.00 3.85 10.00 3.85 33K105011Total coated tablet 260.00 100.00 260.00 100.00

TABLE 7 20 mg Olanzapine/10 mg Samidorphan Tablet Compositions AmountAmount Amount Amount (mg) (% wt) (mg) (% wt) per per per per tablettablet tablet tablet Component Formulation A Formulation B Olanzapine20.00 6.41 20.00 6.41 Samidorphan L-malate 13.62 4.37 13.62 4.37Microcrystalline cellulose, 120.00 38.46 120.00 38.46 NF Lactosemonohydrate, NF 137.13 43.95 137.88 44.19 Crospovidone, NF 4.00 1.284.00 1.28 Colloidal silicon dioxide, 1.50 0.48 1.50 0.48 NF Magnesiumstearate, NF 3.75 1.20 3.00 0.96 Total uncoated tablet 300.00 300.00Film coat suspension Opadry ® II pink 33K140002 12.00 3.85 12.00 3.85Total coated tablet 312.00 100.00 312.00 100.00

TABLE 8 Olanzapine Blend Compositions for tablet layer inclusion % wtFormulation Formulation Component A and B C Olanzapine 10.00 9.95Microcrystalline cellulose, NF 40.00 39.80 Lactose monohydrate, NF 47.5047.26 Crospovidone, NF 1.00 1.00 Colloidal silicon dioxide, NF 0.50 1.00Magnesium stearate, NF 1.00 0.99 Total 100.0 100.00

An alternative olanzapine layer blend for a 10 mg samidorphan and 2.5 mgolanzapine bilayer tablet formulation is shown below:

TABLE 9 Alternative Olanzapine Blend Compositions for tablet layerinclusion (2.5 mg Olanzapine strength) Amount (mg) Amount (% wt)Component per tablet per coated tablet Olanzapine 2.5 5.00Microcrystalline cellulose, NF 21.14 42.28 Lactose monohydrate, NF 25.1150.22 Crospovidone, NF 0.50 1.00 Colloidal silicon dioxide, NF 0.25 0.5Magnesium stearate, NF 0.5 1.00 Total uncoated tablet 50.00 100

TABLE 10 Samidorphan Blend Compositions % wt Formulation FormulationFormulation Component A B C Samidorphan L-malate 13.62 13.62 13.55Microcrystalline 40.00 40.00 39.80 cellulose, NF Lactose monohydrate,42.13 42.88 42.67 NF Crospovidone, NF 2.00 2.00 1.99 Colloidal silicon0.50 0.50 0.99 dioxide, NF Magnesium stearate, NF 1.75 1.00 1.00 Total100.0 100.00 100.00

The same excipients were used in both layers and at similar ratios whichminimizes the potential of layer separation due to differences inviscoelastic properties between the layers. Microcrystalline celluloseand lactose monohydrate are used as diluents, crospovidone as adisintegrant, colloidal silicon dioxide as a glidant and magnesiumstearate as a lubricant. The HPMC-based Opadry® II, a non-functionalfilm coating, was selected to mask the yellow color of the olanzapinelayer and to provide differentiation across product strengths, inaddition to tablet size and debossment.

The bilayer tablet composition was optimized to i) minimizingfriability, (ii) maximizing the olanzapine layer disintegration toapproximate that of the total tablet (i.e., samidorphan layer) and to(iii) maximizing hardness, and compactibility profile R2. The lattercriterion was selected to ensure the composition was not subject toover-compression, which could lead to tablet defects such as capping anddelamination. Separation of layers after compression, was assessedindirectly via observation of fracture mode during hardness testing andtablet disintegration behavior (i.e., disintegration as two independentlayers or a whole tablet). The individual blends required to make eachoptimal tablet composition were the same for all the tablet strengths.This was not necessarily expected a priori but is advantageous formanufacturing operations. The excipient levels were either similar orthe same between olanzapine and samidorphan layers thereby providingsimilar viscoelastic response on compression and reducing the potentialfor delamination. A subsequent increase to the amount of crospovidonefrom 1% to 2% in the SAM blend was made to achieve rapid dissolution ofsamidorphan and define the initial clinical composition known asFormulations B and C described herein.

During further development of Formulation B, undesirable tablet pickingwas identified during the evaluation of compaction profiles; picking wasobserved on the SAM layer punch face resulting in picking of the SAMlayer. Subsequent compression studies identified the extent oflubrication as the root cause. A lubrication level optimization DOE wasperformed to map the formulation and process space for varying levels ofmagnesium stearate (from 1.00% wt/wt to 2.00% wt/wt) in the samidorphanlayer. The study was performed using the 5 mg/10 mg bilayer tablet, asthese tablets consistently exhibited the worst tablet picking.Samidorphan blends were evaluated for flowability, and bilayer tabletsfor picking, hardness, friability, disintegration time, and dissolution.Tablet picking was assessed to determine if the appearance CQA targetwas met. The results showed that the level of magnesium stearate had asignificant effect on tablet picking. Based on the acceptable rangesidentified, a level of 1.75% wt./wt. magnesium stearate was selected forthe SAM layer to eliminate tablet picking. This change resulted inFormulation A, which did not have an impact on any of the other CQAs.

Example 4. In Vitro Dissolution Testing of Tablets

Dissolution tests of the bilayer tablets were performed. Dissolution wasperformed over pH 1 to 6.8. Twelve tablets (n=12) were analyzed per drugproduct lot at each pH condition. The pH values and media used fordissolution testing were pH 1 (0.1N hydrochloric acid), pH 4.5 (USPacetate buffer), and pH 6.8 (USP phosphate buffer). The dissolutionmethod parameters (Table 11) included a paddle speed of 75 revolutionsper minute to reduce coning and three-prong sinkers to eliminatesticking of tablets to the dissolution vessel.

TABLE 11 Dissolution Parameter Summary Variable Condition DissolutionApparatus USP Apparatus II - (Paddle Method) Medium Volume 500 mL MediaTemperature 37.0° C. ± 0.5° C. Paddle Speed 75 rpm Dissolution Media pH1, 0.1N hydrochloric acid (release method) pH 4.5, USP acetate buffer pH6.8, USP phosphate buffer Sinker Three-prong sinker Sampling Time Points5, 10, 15, 30, and 60 minutes Detection Fiber-optic or HPLC

Dissolution Testing of Formulation A.

Dissolution profile overlays of mean data for both olanzapine andsamidorphan L-malate in Formulation A primary and supportive stabilitylots are provided in FIGS. 1A-1F. An additional dissolution profileoverlay of samidorphan L-malate overlaid with the dissolution profile ofolanzapine obtained for Formulation A (10/10) at pH 4.5 is provided asFIG. 14 .

Comparative Dissolution Testing of Formulations B and C.

Comparable dissolution was demonstrated for the change in CSD betweenFormulations C and B. Tablets were very rapidly dissolving forolanzapine in pH 1 and 4.5 media. At pH 6.8, olanzapine dissolutionslowed due to proximity of the olanzapine pKa values (5.44 and 7.80) tothe media pH value, but was similar (f2=85). Tablets were very rapidlydissolving for samidorphan L-malate in all dissolution media. The changein level of CSD did not affect the dissolution of olanzapine andsamidorphan L-malate. Dissolution profile overlays of mean data forolanzapine and samidorphan L-malate are provided in FIGS. 2A-2F.

Comparative Dissolution Testing of Formulations B and A.

Comparative dissolution was evaluated using the application releasedissolution method to assess the impact of a change in the magnesiumstearate between Formulation B and Formulation A. Formulations B and Ain the 10 mg/10 mg, 15 mg/10 mg and 20 mg/10 mg tablets had equivalentdissolution profiles in the release method. Tablets were very rapidlydissolving for both olanzapine and samidorphan. The change in level ofmagnesium stearate did not affect the dissolution of olanzapine orsamidorphan L-malate. Dissolution profile overlays of mean data forolanzapine and samidorphan L-malate from a comparative study using theapplication release method are provided in FIGS. 3A-3B. The Averagedissolution values are also depicted below in Tables 12-14. Note thatDissolution percent is based on the dose strength. For a given batch oftablets there is a distribution of drug amount within the tablets aroundthe mean of the dose strength target. Thus the majority of tablets willhave the target mean amount (i.e., 10 mg for samidorphan) but some mayhave a little more and some a little less than the target. Greater than100% would imply that a particular tablet had slightly more drug thanthe target dose. Plateau of the curve in each instance however is anindication of complete release.

TABLE 12 Average Dissolution Values - pH 1.0 (0.1N HCl) PercentDissolved Tablet Formulation Olanzapine Samidorphan Time (Minutes) 0 510 15 30 60 0 5 10 15 30 60 5 mg OLZ/10 mg SAM (Primary) 0 105 105 105105 105 0 98 98 99 98 98 5 mg OLZ/10 mg SAM (Supportive) 0 98 103 103103 103 0 100 100 100 100 101 10 mg OLZ/10 mg SAM (Primary) 0 103 106106 106 106 0 95 98 98 98 98 15 mg OLZ/10 mg SAM (Primary) 0 102 104 104104 104 0 95 97 97 97 97 20 mg OLZ/10 mg SAM (Primary) 0 101 104 104 104104 0 101 104 104 104 104 20 mg OLZ/10 mg SAM (Supportive) 0 101 103 103103 103 0 106 107 107 107 107

TABLE 13 Average Dissolution Values - pH 4.5 Percent Dissolved TabletFormulation Olanzapine Samidorphan Time (Minutes) 0 5 10 15 30 60 0 5 1015 30 60 5 mg OLZ/10 mg SAM (Primary) 0 94 100 100 100 100 0 99 99 99 9999 5 mg OLZ/10 mg SAM (Supportive) 0 70 92 98 100 100 0 99 100 100 100100 10 mg OLZ/10 mg SAM (Primary) 0 91 100 101 102 102 0 96 97 98 98 9815 mg OLZ/10 mg SAM (Primary) 0 91 99 100 100 101 0 97 99 99 99 99 20 mgOLZ/10 mg SAM (Primary) 0 88 97 99 101 101 0 98 101 101 101 100 20 mgOLZ/10 mg SAM (Supportive) 0 88 97 99 100 101 1 102 105 105 105 105

TABLE 14 Average Dissolution Values - pH 6.8 Percent Dissolved TabletFormulation Olanzapine Samidorphan Time (Minutes) 0 5 10 15 30 60 0 5 1015 30 60 5 mg OLZ/10 mg SAM (Primary) 0 20 41 53 72 85 0 91 93 94 94 955 mg OLZ/10 mg SAM (Supportive) 0 11 27 40 68 86 0 95 95 96 96 97 10 mgOLZ/10 mg SAM (Primary) 0 19 41 55 78 94 0 95 96 97 97 98 15 mg OLZ/10mg SAM (Primary) 0 21 43 57 80 94 0 93 95 94 96 97 20 mg OLZ/10 mg SAM(Primary) 0 18 41 55 78 93 0 87 98 99 100 101 20 mg OLZ/10 mg SAM(Supportive) 0 21 41 55 77 92 0 96 101 101 103 104

Example 5. Samidorphan L-Malate Particle Size Comparability Studies

For samidorphan L-malate, a recrystallization process was implementedproviding particle size control during manufacturing to intentionallytarget a particle size distribution similar to the size of the drugproduct filler excipients. Unmilled and recrystallized grades ofsamidorphan L-malate were characterized for particle size distributionusing 3 unique lots of each. The particle size of unmilled (Primary) andrecrystallized samidorphan L-malate (Supportive) batches are presentedin Table 15. The recrystallization was targeted to produce material withless fine particles thus increasing the D10. A slight increase in theD50 and decrease in the D90 adjusted the centerpoint of the distributionand decreased the overall span of the distribution. Overall therecrystallized materials had tighter distributions and reduced lot tolot variability, indicating better control. No change in the solid stateform was observed between unmilled and recrystallized samidorphanL-malate as assessed by PXRD spectral comparison.

TABLE 15 Particle Size for Unmilled and Recrystallized SamidorphanL-Malate. Unmilled Recrystallized Sample Sample number (par- number(par- ticle size ticle size measure- Particle size (μm) measure-Particle size (μm) ment) D₁₀ D₅₀ D₉₀ ment) D₁₀ D₅₀ D₉₀ 1 8 37 223 4 3373 130 2 10 36 231 5 46 90 160 3 6 28 243 6 42 90 165

Example 6. Stability Studies of Bilayer Tablets

The tablets are manufactured according to the manufacturing process ofExample 2. Eight primary batches were manufactured. Seven of these wereplaced on primary stability, three 5 mg/10 mg OLZ/SAM batches, one 10mg/10 mg OLZ/SAM batch, and three 20 mg/10 mg OLZ/SAM batches. Twosupportive batches, one 5 mg/10 mg OLZ/SAM and one 20 mg/10 mg OLZ/SAM,were also manufactured. Three packaging configurations were employed forstability analysis, 5-count in a 30 cc HDPE induction-sealed bottle withdesiccant, and 30-count and 100-count into 60 cc HDPE induction-sealedbottles with desiccant. Table 16 summarizes the package batches used inthe primary stability studies.

The statistical analysis of all long-term stability data was performedaccording to the approach detailed in ICH Q1E. Regression analysis wasutilized to evaluate the stability data for the quantitative attributesand establish an expiry period. Expiry period for each attribute wasperformed by determining the earliest time at which the 95% confidencelimit for the mean intersects the proposed acceptance criteria. Foracceptance criteria with an upper limit, the upper one-sided 95%confidence limit was compared to the acceptance criteria. For acceptancecriteria with a lower limit, the lower one-sided 95% confidence limitwas compared to the acceptance criteria. For acceptance criteria withupper and lower limits, the two-sided 95% confidence limit was comparedto the acceptance criteria. Each test is conducted using a significancelevel of 0.05.

SLIMStat® Version 5.0.0 software was used to determine poolability amongsample batches across test attributes and to estimate the product expiryperiod. SLIMStat uses four models to estimate expiry period three ofwhich were required for this analysis: Model 2: Common slope butdifferent intercept; expiration period will be considered the minimum ofthe expiration period of individual studies; Model 4: Differentintercept and different slope; expiration period for individual batchesare estimated by using individual intercepts and individual slopes andthe pooled mean square error calculated from all batches.

TABLE 16 Samples in Exemplary Primary Stability Studies. Dosage StrengthSample (OLZ/SAM) Number Configuration  5 mg/10 mg 1 5-count, 30 cc 2HDPE bottle, 1 g 3 desiccant canister 12 100-count, 60 cc 13 HDPEbottle, 2 g 14 desiccant canister 10 mg/10 mg 4 5-count, 30 cc HDPEbottle, 1 g desiccant canister 8 100-count, 60 cc HDPE bottle, 2 gdesiccant canister 20 mg/10 mg 5 5-count, 30 cc 6 HDPE bottle, 1 g 7desiccant canister 9 100-count, 60 cc 10 HDPE bottle, 2 g 11 desiccantcanister

For a given test attribute across multiple batches in Table 16, theshortest expiry period was reported based on the regression analysismodel (Model 2 or 4 as described above) referenced for that testattribute as detailed in Table 17.

TABLE 17 Expiry Period Determination. Regression Test Attribute ModelAnalysis Expiry Assay 2 FIG. 4 OLZ 113 months % 2 FIG. 4 SAM  84 monthsHighest Related 2 FIG. 5 211 months Impurity (% wt/wt) Total Related 2FIG. 6 1331 months  Impurities (% wt/wt) Dissolution, 2 FIG. 7 OLZ 211months % release at 30 minutes 4 FIG. 8 SAM  54 months Water Content (%wt/wt) 4 FIG. 10  51 months

For batches in Table 17, regression analyses of test attributes (Assayfor %, Highest Related Impurity, Total Related Impurities, Dissolution,% release at 30 minutes, and Water Content) are provided in FIGS. 4, 5,6, 7, 8, 9, and 10 , respectively.

The supportive stability batches were packaged identically to theprimary stability batches. The results of the statistical analysisdemonstrate that the stability data from the supportive batches arecomparable to the stability data from the primary stability batches.

In-Use Stability Study.

An in-use stability study was conducted to unit dose repackaging in ahospital setting. The stability study is currently ongoing utilizing one5 mg/10 mg OLZ/SAM batch and one 20 mg/10 mg OLZ/SAM batch stored at theintended storage condition of 25° C.±2° C./60%±5% RH. To reproducerepresentative hospital handling, the samples were repackaged into amberunit-dose blisters. Exemplary results for each batch up to 6 months areshown in Table 18 (5 mg/10 mg OLZ/SAM) and Table 19 (20 mg/10 mgOLZ/SAM).

TABLE 18 5 mg/10 mg OLZ/SAM Results for In-Use Stability Study at 25°C./60% RH. Test Initial 3 months 6 months Description Conforms ConformsConforms Assay (%) OLZ SAM OLZ SAM OLZ SAM 101.0%   99.7%  99.8% 100.0%   99.5%  99.3%  Total Related Impurities 0.1% 0.1% 0.2% (% wt/wt)Dissolution OLZ SAM OLZ SAM OLZ SAM (% Release at 30 min) 103% 101% 102%100% 101% 100% Water Content (% wt/wt) 4.7% 5.1% 5.4%

TABLE 19 20 mg/10 mg OLZ/SAM Results for In-Use Stability Study at 25°C./60% RH. Test Initial 3 months 6 months Description Conforms ConformsConforms Assay (%) OLZ SAM OLZ SAM OLZ SAM 101.1%   101.7%   100.7%  101.5%   100.3%   101.2%   Total Related Impurities 0.0% 0.1% 0.1% (%wt/wt) Dissolution OLZ SAM OLZ SAM OLZ SAM (% Release at 30 min) 103%102% 103% 104% 101% 102% Water Content (% wt/wt) 4.7% 5.1% 5.2%

Example 7: Clinical Study 1

Clinical Study 1 was a Phase 1, multicenter, open-label, randomizedstudy designed to determine the steady-state pharmacokinetic profile ofolanzapine and samidorphan and to evaluate the safety and tolerabilityof olanzapine and samidorphan bilayer tablets in adult subjects withschizophrenia following 14 consecutive days of oral administration.

Prior to commencement, subjects taking antipsychotic medication at studyentry were tapered off their medication and titrated to olanzapine (15mg/day) during a 1 week lead-in period. Following olanzapine lead-in, 42subjects were randomly assigned (1:1) to receive an oral bilayer tabletof Formulation C (10/10, i.e. 10 mg olanzapine and 10 mg samidorphan asdescribed in Table 4 herein) once daily or Formulation B (20/10, i.e. 20mg olanzapine and 10 mg samidorphan as described in Table 6 herein) oncedaily for 14 days (Days 1 to 14).

Blood samples for PK assessments were collected before dosing (predose)and at 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, and 24 h after dosing ofFormulations B (20/10) and C (10/10) described above on Day 1 and Day14. Additional trough samples were collected predose on Days 3 to 13 ofthe study.

Pharmacokinetic Results

Mean steady state (Day 14) olanzapine and samidorphan plasmaconcentration-time profiles for both treatment groups are presented inFIG. 11 and FIG. 12 respectively. The key steady state pharmacokineticparameters are summarized in Table 20. Steady state (Day 14) olanzapineexposure (maximum plasma concentration (C_(max)) and area under theconcentration-time curve from time 0 to 24 hours postdose (AUC₀₋₂₄)increased dose proportionally with the increase in olanzapine dose from10 mg (Formulation C (10/10)) to 20 mg (Formulation B (20/10)).

After oral administration of Formulation B (20/10) and C (10/10),samidorphan was rapidly absorbed with mean C_(max) reached within 1 hourpost dose. The mean concentration-time profiles of samidorphan werealmost superimposable for both treatment groups (FIG. 12 ).

TABLE 20 Pharmacokinetic parameters for olanzapine and samidorphan afteronce-daily oral administration of Formulation C (10/10) or Formulation B(20/10) for 14 days; Day 14 data. Treatment; PK N Parameter^(a)olanzapine samidorphan Formulation C C_(max) 32.1 43.1 10/10 QD (ng/mL)(12.4) (11.4) N = 21 t_(max) 3 1 (hr) (1.00, 8.00) (0.48, 3.00) AUC₀₋₂₄533 360 (ng · hr/mL) (196) (99.5) Formulation B C_(max) 64.6 46.0 20/10QD (ng/mL) (28.9) (15.1) N = 21 t_(max) 3 1 (hr) (0.98, 8.20) (0.48,4.00) AUC₀₋₂₄ 1086 364 (ng · hr/mL) (556) (112) ^(a)Data are presentedas Arithmatic Mean (SD) except for t_(max), which is summarized asmedian (minimum, maximum). Abbreviations: AUC₀₋₂₄ = area under theconcentration-time curve from time 0 to 24 hr; C_(max) = maximumobserved concentration; QD = once daily; SD = standard deviation t_(max)= time to maximum observed concentration.

The pharmacokinetic profile of olanzapine, as a component of FormulationB and Formulation C, was found to be comparable with previouslypublished data for olanzapine administered alone (see e.g. Callaghan JT, Bergstrom R F, Ptak L R, Beasley C M. Olanzapine: pharmacokinetic andpharmacodynamic profile. Clin Pharmacokinet. 1999; 37:177-193). Thepharmacokinetic profile of samidorphan was not affected by differentdose levels of olanzapine in the combination. The data from this studyindicated that combining olanzapine with samidorphan in a bilayer tabletdoes not affect the pharmacokinetic profile of either drug.

Example 8: Clinical Study 2

This study was a Phase 1, single-center, open-label, randomized,balanced, crossover design study in a total of 48 healthy subjects todetermine the relative bioavailability of olanzapine after single doseoral administration of the bilayer tablet of Formulation C,olanzapine/placebo bilayer tablet (referred to herein as ALKSolanzapine), and a branded olanzapine tablet marketed under the brandname Zyprexa® (registered trademark of Eli Lilly and Company), referredto herein as Branded olanzapine. The study was designed and powered toevaluate the bioequivalence of olanzapine between the threeolanzapine-containing tablet formulations.

The study consisted of three periods, each including a 4-day inpatientstay and a 5-day outpatient follow-up. A single dose of study drug wasadministered on Day 1 of each period separated by a 14-day washoutbetween doses. Subjects meeting the eligibility criteria receives asingle dose of Formulation C (10/10) (10 mg olanzapine and 10 mgsamidorphan) as described in Example 3, table 5 above, ALKS olanzapinewhich was a 10 mg olanzapine/placebo bilayer tablet, and Brandedolanzapine (10 mg olanzapine) on Day 1 of Period 1.

Blood samples for PK assessments were collected within 15 minutes beforedosing (predose) and 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, 24, 32, 48,72, 96, 120, and 168 hours postdose.

Pharmacokinetic Results

The pharmacokinetic profiles of olanzapine after a single doseadministration of Formulation C (10/10), ALKS Olanzapine (10 mg), andBranded olanzapine (10 mg) were superimposable (FIG. 13 ).Pharmacokinetic parameters, including C_(max), t_(max), AUC_(last), andAUC_(∞), are summarized in Table 21. The olanzapine component inFormulation C (10/10) and ALKS Olanzapine bilayer tablets wasdemonstrated to be bioequivalent to the Branded olanzapine.

TABLE 21 Pharmacokinetic parameters for olanzapine after single-doseadministration of Formulation C (10 mg olanzapine/10 mg samidorphan),ALKS olanzapine (10 mg olanzapine/placebo bilayer tablet) and Brandedolanzapine (10 mg olanzapine) Formulation C ALKS olanzapine BrandedParameter (10 mg samidorphan/ (10 mg olanzapine/ olanzapine Statistics10 mg olanzapine) placebo) (10 mg)) n 46 45 48 C_(max), ng/mL 16.6 (4.5)16.7 (4.2) 16.6 (3.8) Mean (SD) tmax, h 7.0 (2.0-16.0) 5.0 (2.0-12.0)5.0 (2.0-12.0) Median (min-max) AUC_(0-t), ng h/mL 610.6 (215.7) 599.1(187.8) 594.3 (190.8) Mean (SD) AUC_(0-∞), ng h/mL 652.0 (226.5) 629.2(205.0) 632.6 (197.2) Mean (SD) Abbreviations: C_(max) = maximum plasmaconcentration t_(max) = time to reach maximum plasma concentrationAUC_(∞) = area under the plasma concentration-time curve from time zeroextrapolated to infinity AUC_(0-t) = area under the plasmaconcentration-time curve from time zero until the last measurableconcentration time point SD = standard deviation n = number of subjectswhose parameter values are in the summary statisticsSamidorphan Administered as a Component in Formulation C compared withSamidorphan Administered Alone

Key pharmacokinetic parameters of samidorphan after a single doseadministration of Formulation C (10 mg olanzapine/10 mg samidorphan) aredepicted below in Table 22. For comparison, these parameter values areshown alongside data obtained from a separate clinical study conductedby the Applicant, when administered as samidorphan alone in tablet form.

TABLE 22 Pharmacokinetic Parameters for Samidorphan after single-doseadministration of Formulation C (10 mg olanzapine/10 mg samidorphan) ascompared to samidorphan alone in selected studies TreatmentOlanzapine/samidorphan Samidorphan alone (Dose) (10 mg/10 mg) (10 mg)Study Type Clinical Study 2 Human Abuse Potential Study Study (N) 45 56C_(max) (ng/mL) 27.8 (9.9) 28.2 (6.2) Mean (SD) t_(max), (h) 2.0(0.5-6.0) 1.5 (0.5-4.0) Median (min- max) AUC_((0-t)), 240.0 (57.6)224.9 (55.9) (h · ng/mL) Mean (SD) AUC_((0-∞)), 245.6 (56.9) 230.1(56.7) (h · ng/mL) Mean (SD) Abbreviations: C_(max) = maximum plasmaconcentration; t_(max) = time to reach maximum plasma concentrationAUC_(∞) = Area under plasma concentration time curve extrapolated toinfinity; AUC_((0-t)), area under the plasma concentration-time curvefrom zero to the last quantifiable concentration N = number of subjectsper treatment group; SD = standard deviation

The above studies clearly demonstrate that when Formulation C (10/10)was administered in vivo, the pharmacokinetic profile of the samidorphanand olanzapine were not significantly affected by presenting bothactives together in a bilayer configuration.

EQUIVALENTS

While specific embodiments have been discussed, the above specificationis illustrative and not restrictive. Many variations of the presentdisclosure will become apparent to those skilled in the art upon reviewof this specification. The full scope of the present disclosure shouldbe determined by reference to the claims, along with their full scope ofequivalents, and the specification, along with such variations.

What is claimed is:
 1. A method of treating schizophrenia or bipolar I disorder in a patient in need thereof, the method comprising orally administering to the patient, once daily, a pharmaceutically acceptable coated immediate release bilayer tablet for orally delivering a fixed dose of olanzapine and 10 mg of samidorphan, wherein the bilayer tablet comprises: a first tablet layer comprising: 10 mg samidorphan or a pharmaceutically acceptable salt of samidorphan in an amount to deliver 10 mg samidorphan; about 35-43 wt % microcrystalline cellulose, based on the weight of the first tablet layer; about 37-43 wt % lactose or a hydrate thereof, based on the weight of the first tablet layer; and about 1.5 to about 2 wt % magnesium stearate; a second tablet layer comprising: a dose of olanzapine selected from the group consisting of 5 mg, 10 mg, 15 mg and 20 mg of the olanzapine; about 38-42 wt % microcrystalline cellulose, based on the weight of the second tablet layer; about 46-49 wt % lactose or a hydrate thereof, based on the weight of the second tablet layer; and about 1.0 wt % magnesium stearate; and a film coating over the first and second tablet layer.
 2. The method of claim 1, wherein the tablet releases at least 97% of olanzapine and at least 97% of the samidorphan after 30 minutes when the tablet is tested in 500 mL USP acetate buffer at pH 1.0 using a USP Apparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpm and using a three-prong sinker.
 3. The method of claim 1, wherein the tablet releases at least 97% of olanzapine and at least 97% of the samidorphan after 30 minutes when the tablet is tested in 500 mL USP acetate buffer at pH 4.5 using a USP Apparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpm and using a three-prong sinker.
 4. The method of claim 1, wherein the pharmaceutically acceptable salt of samidorphan in amount to deliver 10 mg samidorphan is 13.6 mg samidorphan L-malate.
 5. The method of claim 1, wherein less than 0.5 wt % impurities from olanzapine degradation are detected, using HPLC, after the tablet is stored for 6 month in a closed container containing 250 g silica gel desiccant at 25° C. and 60% relative humidity.
 6. The method of claim 1, wherein the first tablet layer further comprises about 2.0 wt % crospovidone and the second tablet layer further comprises about 1.0 wt % crospovidone.
 7. The method of claim 1, wherein the dose of olanzapine is 5 mg.
 8. The method of claim 1, wherein the dose of olanzapine is 10 mg.
 9. The method of claim 1, wherein the dose of olanzapine is 15 mg.
 10. The method of claim 1, wherein the dose of olanzapine is 20 mg.
 11. A method of treating schizophrenia or bipolar I disorder in a patient in need thereof, the method comprising orally administering to the patient, once daily, a pharmaceutically acceptable coated immediate release bilayer tablet for orally delivering a fixed dose of olanzapine and 10 mg of samidorphan, wherein the bilayer tablet comprises: a first tablet layer comprising: 13.6 mg samidorphan L-malate; about 40 wt % microcrystalline cellulose, based on the weight of the first tablet layer; about 42 wt % lactose monohydrate, based on the weight of the first tablet layer; and about 1.75 wt % magnesium stearate; and a second tablet layer comprising: a dose of olanzapine selected from the group consisting of 5 mg, 10 mg, 15 mg and 20 mg of the olanzapine; about 40 wt % microcrystalline cellulose, based on the weight of the second tablet layer; about 47 wt % lactose or a hydrate thereof, based on the weight of the second tablet layer; and about 1.0 wt % magnesium stearate; and a film coating over the first and second tablet layer.
 12. The method tablet of claim 11, wherein the samidorphan L-malate has a particle size distribution (D10) of about 10 μm to about 80 μm, a particle size distribution (D50) of about 40 μm to about 200 μm, and a particle size distribution (D90) of about 100 μm to about 300 μm.
 13. The method of claim 12, wherein the tablet releases at least 97% of olanzapine and at least 97% of the samidorphan after 30 minutes when the tablet is tested in 500 mL USP acetate buffer at pH 1.0 using a USP Apparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpm.
 14. A method of treating schizophrenia or bipolar I disorder in a patient in need thereof, the method comprising orally administering to the patient, once daily, a pharmaceutically acceptable coated immediate release bilayer tablet for orally delivering olanzapine and 10 mg of samidorphan as a fixed dose, comprising: a first tablet layer comprising: 10 mg samidorphan or a pharmaceutically acceptable salt of samidorphan in an amount to deliver 10 mg samidorphan; about 35-43 wt % microcrystalline cellulose, based on the weight of the first tablet layer; and about 37-43 wt % lactose or a hydrate thereof, based on the weight of the first tablet layer; a second tablet layer comprising: a dose of olanzapine selected from the group consisting of 5 mg, 10 mg, 15 mg and 20 mg of the olanzapine; about 38-42 wt % microcrystalline cellulose, based on the weight of the second tablet layer; about 46-49 wt % lactose or a hydrate thereof, based on the weight of the second tablet layer; and a film coating over the first and second tablet layer; wherein the bi-layer tablet releases at least 85% of olazanpine and at least 85% of the samidorphan after 15 minutes when the bi-layer tablet is tested in 500 mL USP acetate buffer at pH 4.5 using a USP Apparatus II (Paddle Method) at 37° C., with a paddle speed of 75 rpm and using a three-prong sinker.
 15. A method of treating schizophrenia or bipolar I disorder in a patient in need thereof, the method comprising orally administering to the patient, once daily, a pharmaceutically acceptable coated immediate release bilayer tablet for orally delivering, as a fixed dose, olanzapine and 10 mg of samidorphan wherein the bilayer tablet, comprises: a first tablet layer comprising: 10 mg samidorphan or a pharmaceutically acceptable salt of samidorphan in an amount to deliver 10 mg samidorphan; about 30-45 wt % microcrystalline cellulose, based on the weight of the first tablet layer; about 35-50 wt % lactose or a hydrate thereof, based on the weight of the first tablet layer; a second tablet layer comprising: a dose of olanzapine selected from the group consisting of 2.5 mg, 5 mg, 10 mg, 15 mg and 20 mg of the olanzapine; about 35-45 wt % microcrystalline cellulose, based on the weight of the second tablet layer; about 45-55 wt % lactose or a hydrate thereof, based on the weight of the second tablet layer; and a film coating over the first and second tablet layer. 